Healthcare Provider Details

I. General information

NPI: 1952366072
Provider Name (Legal Business Name): JOHN M KEGGI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 03/13/2020
Certification Date: 03/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1579 STRAITS TURNPIKE, SUITE E ORTHOPAEDICS NEW ENGLAND PC
MIDDLEBURY CT
06762
US

IV. Provider business mailing address

1579 STRAITS TURNPIKE, SUITE E ORTHOPAEDICS NEW ENGLAND PC
MIDDLEBURY CT
06762
US

V. Phone/Fax

Practice location:
  • Phone: 203-598-0700
  • Fax: 877-345-6922
Mailing address:
  • Phone: 203-598-0700
  • Fax: 877-345-6922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number031073
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: